Predictive Factors for Preterm Birth by the Evaluation of Uterine Cervical Stiffness During Pregnancy Using Shear Wave Elastography

Background and Aims: The uterine cervix plays a crucial role in ensuring a pregnancy reaches full term for the complete development of the fetus. However, as pregnancy nears its end, the cervix undergoes significant softening, shortening, and dilation to facilitate delivery. Spontaneous preterm birth, the leading cause of death in children under 5 globally, can occur through various pathways, all converging on premature changes in the cervix as the final common step leading to delivery. Methods: This cross-sectional analytical study was conducted in the Radiology Department of Chaudhry Muhammad Akram Teaching and Research Hospital, Lahore, Punjab, Pakistan. The sample size comprised 111 participants, selected through probability sampling. The study focused on pregnant females aged 18 to 40. The inclusion criteria encompassed pregnant women within the specified age range, while exclusion criteria involved uncooperative patients and females presenting with other pathologies. The ECHOSENS FibroScan 402 Sono elastography machine, equipped with a probe frequency range of 3 to 12 MHz for both Transabdominal and Transvaginal assessments, was employed for data collection. This comprehensive methodology aimed to systematically investigate and analyze uterine cervical stiffness during pregnancy using advanced elastography technology. Results: Our study involved 111 participants, with an average age of 29.6 years and a median parity of 2. Examining the cervical characteristics, we found that the mean cervical length was 35.1 mm with a standard deviation of 8.2 mm, while the mean Shearwave Elastography was 2.3 kPa with a standard deviation of 0.6 kPa. Drawing from our sample of 111 observations, a robust correlation analysis revealed a compelling relationship between Cervical Length and Shearwave Elastography. The correlation coefficient of .557, coupled with a highly significant p-value of .000, underscores a strong and consistent monotonic trend. Conclusion: In conclusion, our study reinforces the clinical significance of elastography ultrasound in assessing cervical stiffness during pregnancy.